20030189 Ver 1_Certification of Completion_20041103

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DWQ Project No.: O 3-C~/g `1 Counh/: /~c.~~Pi~'~
Applicant: j~r/I~G~i_~ /~y.o P~~''s, ~- L~-
Project Name: ~o wt ~s ~ ~ ~'"~ C ~`~ ~~
Date of Issuance of 401 Water Quality Certification: ~_~ ~ ~' ~ °y ~
Certificate of Completion
Upon completion of all work approved within the 40.1 Water Quality Certification and Buffer Rules, and any
subsequent modifications, the applicant is ,required to return this certificate to the 401/V1/etlands Unit, North
Carolina Division cf `JVater Cualiry, 1621 Mail Service Center, Raleigh, NC, 27699-1621. This form may be
returned to DWQ by the applicant, the applicant's authorized agent, or the project engineer. It is not
necessary to send certificates from all of these.
Applicant's Certification
l~ ~~~a ~~u~l ,hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to be-built
within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the
approved plans ands ec'ficatio ,and other supporting materials.
Signature: Date: ~a'.?° ' u `~
Agent's Certification
I ,hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to be built
within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials. (~
Si nature: Date: ~ ~' ~~~
g
NOV ~ 3 2004
If this project was designed by a Certified Professional ~~r~R.WAT~RQUALITY
YET~ DS ~!D STOR!uIWATER BRANCH (i . e . ,
I _, as a duly registered f~rotessional
Engineer, Landscape Architect. Surveyor, etc.) in the State of North Carolina, having been authorized to
observe (periodically, weekly; full time) the construction of the project, for the Permittee hereby state that, to
the best of my abilities, due care and, diligende was used in the observation of the construction such that the
construction was observed tc be built within substantial compliance and intent of the 401 1Nater Quality
Certification and Buffer Rules. the approved plans and specifications, and other supporting materials.
Signature:
Registration No
Date
Michael ~_. Easley, Govemcr
'JJiliiam G. Ross Jr., Secretary
North Carolina Cepar^tent of Environment and Natural Resources
4ian V`J. Klimek, P-E., Director
Division of Water C`uaiR;~

N. C. Division of Water Guaiity, 401 4Vet;anLs Cartitication Unit,
1650 Mail Service Center, Raleigh. NC 270=-1650 (Mailine Address;
~3~1 Crabtree Blvd., r,sieigh, NC X7604-c=~0 (Location;
(~i91 733-1786 (phone;. 9'9-X33-eS93 (`a::'. ';http:;,h2o.enr.state.nc.us/ncwetlands